HomeMy WebLinkAboutPR16-1085LUIOND BAR
CITY OF DIAMOND BAR
DEPARTMENT OF COMMUNITY%& DEVZLOPMENT SERVICES
21810 Copley Drive, Diamond Bar, CA 91765
(909) 839-7020 Fax: (909) 861-3117 Building Inspection Hotline (909) 83 -702
BUILDING PERMIT APPLICATION www.cityofdiamondbar.com bui 'ndbarca.gov
JOB SITE ADDRESS 2
APN LOT TRACT
OWNER Gh 1Z Or CA YI
ADDRESS G ✓1iI
CITY 1/ 1141✓W,? ,A LJ X_ ZIP I �i TEL. 0 e l ' O
APPLICANTLI9) 11114;- t,40 -5 TEL. 45 J I q- 9160
CONTRACTOR LJ
ADDRESS ' 1 L II y� ✓� 4111 I 1
CITY tM 1 9A j t2-.AA1 ZIP 611 -IC EL. W;973' P,!E: I$ S 5'
ARCH/ENG/
DESIGNER
ADDRESS
CITY ZIP TEL.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the reason(s)
indicated below by the checkmark(s), I have placed next to the applicable item(s) [Section 7031.5, Business and
Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair, any
structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she
is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9) Commencing with Section
7000 of Division 3 of the Business and Professions Code] or that he or she is exempt from licensure and the basis for
the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty
of not more than five hundred dollars ($500).
V 1, as owner of the property, or my employees with wages as their sole compensation, will do U all of or (_J portions
of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds
or improves the property, provided that the improvements are not intended or offered for sale. If however, the building or
improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built
or improved for the purpose of sale.).
( 11, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who
builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State
License Law.).
U I am exempt from licensure under the Contractor's State License law for the following reason(s):
By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one
year prior to completion of the improvements covered by this permit,l cannot legally sell a structure that I have built as an
owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the
applicable law, Section 7044 of the Business and Professions Code is available upon request when this application is
submitted or at the following Web site: http/www.leginfo.ca.gov/calaw.htmi.
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000)
of Division 3 of the Business and Professions Code, and my license is in full
�force
anand effect.
LICENSE C :�� 6 LIC. NO.:
DATE: CONTRACTOR: . I/ [0 a
111 3 7 ,� 1-1 WORKER'S COMPENSATION DECLARATION
I HEREBY AFFIRM UNDER PENALTY OF PERJURY ONE OF THE FOLLOWING DECLARATIONS:
I have and will maintain a Certificate of Consent to Self -Insure for Worker's Compensation, as provided by
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
I I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for
the performance of the work for which this permit is issued. My Worker's Compensation Insurance Carrier and
Policy Number are:
CARRIER
POLICY NUMBER
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS).
I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to
become subject to the Worker's Compensation Laws of California. And agree that if I should become subject to the Worker's
Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
DATE: '112-111 APPLICANT:�f
WARNING: Failure to secure Worker's Compensation coverage is unlawful, and shall subject an employer to criminal
penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of the compensation,
damages as provided for in section 3708 of the labor code, interest, and attorney's fees.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a Construction Lending Agency for the performance of the work for
which this permit is issued (Sec. 3097, Civ. C.).
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have read this application and state that the above information is correct. I agree to comply with all city and
county ordinances and state laws relating to building construction, and hereby authorize representatives of this county to
enter upon the above-mentioned property for inspection purposes.
l �j
PERMITT I up������C li�/ _ [ // I
SIGNATURE OF PERMITTEE J DATE
PRESS
FIRMLY
APPLICATION DATE: e P/C#
ISSUE DATE:'—PERMIT# : /' I S- /D��
TYPE CONST. OCC GROUP:
Scope of Work
# DWEL. UNITS # STORIES Z
# BEDROOMS
DESCRIPTION SQ. FT. FACTOR PSF
ADJ. AREANALUATION
SFR/ADD/REM
Garage/Carport
CO
Patio/Deck
W
LL
Pool/Spa
ZRe
-Roof
Commercial
m
Valuation:
Adj. Area:
QUANTITY DESCRIPTION
FEE
U
U
w
w
LL
!
z
in
i
J
a
It el 11, Itgo -C CY141AZZ,
�
( Z !9 � � is 't'O✓I
o t
w
CONSTRUCTION:
PLAN REVIEW:
ELECTRIC:
PLUMBING:
MECHANICAL:
a
INSPECTION FEE:
ISSUANCE:
SMIP:
ENERGY P/C:
ENERGY PERMIT:
RETENTION FEE:
PRE -ALT FEE:
00
BASF:
PLOT PLAN:
ZONING CLEARANCE:
TOTAL FEES
COMMENTS:
P/C: PAID BY: p VALIDATION:
RECEIPT H 44&(y PAID BY: �, O� VALIDATION:
WHITE — Department Copy, YELLOW — Finance Copy, PINK — Assessor Copy
CITY OFWAMOND BAR
®' INSPECTsON RECORD
INSPECTION DATE
O.
SETBACK/ LETTER
FOOTINGS FORMS
SLAB
UG. PLUMBING
UG. ELECTRICAL
UFER GROUND
SEWER LATERAL
MAIN WATER LINE
SEWER CLEANOUT
ROOF SHEATHING
FLOOR SHEATHING
SHEAR WALLS EXTERIOR
SHEAR WALLS INTERIOR
FRAMINGNENTING
ROUGH MECHANICAL
ROUGH ELECTRICAL W( ) C ( )
ROUGH PLUMBING
INSULATION WALL
INSULATION CEILING
DRYWALL
LATH (PRE)
LATH EXTERIOR
LATH INTERIOR
GAS TEST
SCRATCH COAT
ELECTRIC METER RELEASE
GAS METER RELEASE
SPECIAL INSPECTION
FINAL BUILDING /
FINAL MECHANICAL
FINAL ELECTRICAL
FINAL PLUMBING
T.C. of OCCUPANCY
CERT. of OCCUPANCY
COMMENTS:
INSPECTION DATE
O.
TRACT AND LEDGER
SWITCH GEAR
COMMERCIAL HOOD
T -BAR
INTERCEPTER
HOT MOP/SHOWERPAN
SEPTIC/CESSPOOL
HERS REPORT RECEIVED
DEMOLITION
ROOF DRAINS
ROUGH CONDUIT
POOUSPA
ROUGH PLUMBING
ROUGH ELECTRICAL
ROUGH MECHANICAL
GAS TEST
PRE GUNITE
POOL PRE DECK BONDING
P -TRAP
FENCE / GATE/ ALARM
FINAL POOL
WALLS:
WALL FOOTING/STEEL
WALL STEEL 1-( ) 2ND( ) LIFT
WALL BOND BEAM
WALL DRAIN/ SEAL
WALL FINAL
R0. FRAMING PLANNING APPROVAL
ROUGH FIRE APPROVAL
FINAL FIRE DEPARTMENT
FINAL PLANNING
FINAL ENGINEERING/ PW
FINAL COMMUNITY SERVICES
FINAL HEALTH DEPT.
FINAL INDUSTRIAL WASTE
STATE OF CALIFORNIA r
ALTERATIONS — HVAC '
CEC-CFIR-ALT-04-E (Revised 06/14) CALIFORNIA ENERGY COMMISSION
CERTIFICATE OF COMPLIANCE CFIR-ALT-04-E
Alterations - HVAC CZ 2, and 8-15 (formerly CF -IR -ALT -HVAC) (Page 1 of 1)
Site Address: _
�3D CG-z-A-C�
Enforcement Agerity:
Date Prepared:
Permit#:
.-.
Equipment Type
Equipment Efficiency
New Ducting, Plenums, Lineset:
Conditioned
Thermostat
Required R -value
Floor Area (sq ft)
❑ Packaged System
°Split System
Evaporator Coil
1 Condensing Unit
AFUE
COP
E3 R-6 (CZ 2, 8-13) Ducting
8t 11, 14,
Served by system
;frSetback
(If not already
❑ Mini Split
Compressor
20 SEER
HSPFresent,
(CZ 15) Ducting
's)
sqft
10
R-6 (all CZPlenums
P must
❑ Furnace
jZJ Lineset
TXV
_LEER
„%
R-5 or R7.5) Lineseta
be installed)
HERS VERIFICATION SUMMARY Installer determines work to be completed and matches to one of the options below. At permit application this
form is allowed to be filled out by hand. For final inspection all forms are to be registered (no hand filled forms allowed) and a copy left on site.
;91J. HVAC Changeout/Repair
Required Compliance Documents to be left on site for Final:
All Equipment,
CF1R-ALT-02-E
Condenser Unit, Evaporator Coil,
CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24)2 -HERS, MECH-25-HERS'
Compressor, TXV, Lineset,
CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS', MECH-25-HERS2
Air Handler/Furnace' (Can include new ducting)
Installer Requirement: Duct leakage (<_15%, or < 10% to outside, or seal all accessible leaks), Air Flow >_ 300 CFM/ton, Refrigerant Charge.
Exempted from duct leakage testing if:
❑ 1. Duct system registered with HERS provider as previously sealed, or ❑ 2. There is less than 40 linear feet of duct in unconditioned space, or
❑ 3. Existing duct systems are constructed, insulated or sealed with asbestos (list manufacture date of building
❑ 2. New HVAC System Required Compliance Documents to be left on site for Final:
All new equipment and All New Ducts3 CF1R-ALT-02-E
including Mini Split CF2R: MECH-01, MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24) -HERS', MECH-2S-HERS'
CF3R: MECH-20-HERS, MECH-22-HERS, MECH-(23 or 24)-HERS2, MECH-25-HERS2
Mini Splits require CFIR-ALT-02-E, CF2R-MECH-01, and (CF2R-CF3R) MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Fan Efficacy (.58W/CFM), Air Flow >_ 350'CFM/ton (or alternative), Refrigerant Charge
3. All New Ducts with Replacement Required Compliance Documents to be left on site for Final:
All New.Ducts3 and one or more of the following CFIR-ALT-02-E
replaced: Condenser Unit, Evaporator Coil, CF2R: MECH-01, MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Compressor, TXV, Lineset, Furnace' CF3R: MECH-20-HERS, MECH-(23 or 24) -HERS, MECH-25-HERS
Installer Requirement: Duct leakage < 6%, Air Flow> 350 CFM/ton (or alternative), Refrigerant Charge
Exempted from duct leakage testing if: 111. Existing duct systems are constructed, insulated or sealed with asbestos
❑ 4. New Ducting over 40 feet Required Compliance Documents to be left on site for Final:
New ducting but less than All New Ducts' CFIR-ALT-02-E, CF2R: MECH-20-HERS, CF3R: MECH-20-HERS
Installer Required to: Duct leakage (< 15% or, < 10% to outside or, or seal all accessible leaks)
❑ EXCEPTION: Existing duct systems constructed, insulated or sealed with asbestos.
All new ducting R-8 required when more than 40 ft installed and R-6 when less than 40 ft installed. This includes in walls, between floors etc.
' Heating only systems and Air Handler/Furnace changes do not require Air Flow MECH-(23 or 24), or Refrigerant Charge verification MECH-25
3 All New Ducts is when at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused parts from the
dwelling unit's existing duct system (e.g., registers, grilles, boots, air handler, coil, plenums, duct material)
° R-5 (1" thick insulation) for linesets I" and less. R-7.5 (1.5" thick insulation) for linesets over 1 inch. Most mfg will require Suction line Diameter
with insulation as the following 1.5-2T-2%", 2.5-3T-2'/.", 3.5 to 4T-2%", 5T-4'/."
Contractor (Documentation Author's /Responsible Designer's Declaration Statement) "
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the information on this document.
3. That the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24, Parts 1 and 6 of the California Code of Regulations (CCR).
4. That the energy features and performance specifications, materials, components, and manufactured. devices for the building design or
system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the CCR.
S. The building design features or system design features identified on this Certificate of Compliance are consistent with the information
provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement
agency for approval with this building permit application.
Re able Designer Na �
Responsible Designer Signatur
Da,tfIIgned:1
License:.42 e: (0151
Company:
v��cV�E
Address: /(I
02y7ilIS
City/State/Zip:
Phone:
HF7DS I FsSS
For assistance or questions regarchng the Energy Stanrlartis, contact the Energy Hotline at: 1-800-772-3300..
CERTIFICATE OF VERIFICATION
CF3R-MCH-20-H
Duct Leakage Diagnostic Test
(Page 1 of 3 )
Project Name: 530 Cameron Crest Dr.
Enforcement Agency: Diamond
Bar Building Department
Permit Number:
PR16-1085
Dwelling Address: 530 Cameron Crest Dr.
City:
Zip Code:
91765
A. System Information
01
Space Conditioning System Identification or Name
System 1
02
Space Conditioning System Location or Area Served
House
03
Building Type from CF -1R
Single family
04
Verified Low Leakage Ducts in Conditioned Space
No, credit is not taken
04
(VLLDCS) Credit from CF1R?
Total leakage
06
Verified Low Leakage Air Handling Unit Credit from
No, credit is not taken
05
CF1R?
Cooling system method
06
Duct System Compliance Category
Replacement
09
Calculated Target Allowable Duct Leakage Rate (cfm)
120
MCH -20d - Complete Replacement or Altered Duct System
B. Duct Leakage Diagnostic Test
01
Condenser Nominal Cooling Capacity (ton) U.S.
Diem Raters Association
02
Heating Capacity (kBtu/h)
80
03
Conditioned Floor Area served by this HVAC system (ft2)
2835
04
Duct Leakage Test Condition
Test final
05
Duct Leakage Test Method
Total leakage
06
Leakage Factor
.06
07
Air Handling Unit Airflow (AHUAirflow) Determination
Method
Cooling system method
08
Measured AHUAirflow
0
09
Calculated Target Allowable Duct Leakage Rate (cfm)
120
10
Actual duct leakage rate from leakage test measurement
(cfm)
66
11
Compliance Statement: System passes leakage test
Registration Number: 316-A1024585A-M2010171A-M20A Registration Date/Time: 2016-05-04 04:31:40 HERS Provider: USERA
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-05-04 04:32:03
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 2 of 3 )
B. Duct Leakage Diagnostic Test
12 Notes:
C. Additional Requirements for Compliance
01
System was tested in its normal operation condition. No temporary taping allowed.
Outside air (OA) duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage
02
testing. OA ducts used for Central Fan Integrated (CFI) Indoor Air Quality ventilation systems, or Central Fan Ventilation
Cooling Systems, that utilize dampers that open only when OA is required and automatically close when OA is not required,
may configure the OA damper to the closed position during duct leakage testing.
03
If a complete replacement, all supply and return register boots were sealed to the drywall.
04
Building cavities were not used as plenums or platform returns in lieu of ducts.
05
If cloth backed tape was used it was covered with Mastic and draw bands.
06
All connection points between the air handler and the supply and return plenums are completely sealed.
If the system complies using the Smoke Test method, the'smoke'test was conducted;in accordance with -the requirements
07
of Referenk a Residentiali Appendix RA3:1.4.3.6. Systems that comply using smoke test s 'all not be included in sample
groups forHERS verification compliance.
08
VerificatiomStatus�
Pass all applicable requirements are met a
� `� G,
! t. 'a a, r S 1,
09
Correction Notes for this table U.S.
Energy Raters Association
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have
been met unless otherwise noted in the Verification Status and the Corrections Notes in this table.
D. Determination of HERS Verification Compliance
All applicable sections of this document shall indicate compliance with the specified verification protocol requirements in order
for this Certificate of Verification as a whole to be determined to be in compliance.
01 Complies: All specified verification protocol requirements on this document are met.
Registration Number: 316-A1024585A-M2010171A-M20A Registration Date/Time: 2016-05-04 04:31:40 HERS Provider: USERA
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-05-04 04:32:03
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF VERIFICATION CF3R-MCH-20-H
Duct Leakage Diagnostic Test (Page 3 of 3 )
Documentation Author's Declaration Statement
1. 1 certify that this Certificate of Verification documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature: h
Jose Cervantez
''
Date Signed: ,
Company:
JC HERS RATING
2016-05-04
Address:
CEA/ HERS Certification Identification (if applicable):
136 Half Dome Way
1095730
City/State/Zip:
Phone:
Perris CA 92570
951-217-0805
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Verification is true and correct.
2. 1 am the certified HERS Rater who performed the verification identified and reported on this Certificate of Verification (responsible rater).
3. The installed features, materials, components, manufactured devices, or system performance diagnostic results that require HERS verification
identified on this Certificate of Verification comply with the applicable requirements in Reference Appendices RA2, RA3, and the requirements
specified on the Certificate of Compliance for the building approved by the enforcement agency.
4. The information reported o pplicable sections of the of Installation (CF2R),signed and"submitted by the" pe�son(s) responsible for the
2Certificate(s)
construc3 in or installation'conforms tothe-requiremfents specified-on'the'Certificate(s) of"Compliance (CF)1R) approved by the enforcement agency.
5. I will ensure that a registered copy of this,Certificate of Verification shall by posted, or made available with the building permits) issued for the
i- t A a uw > -� - 1: F
building, -and made available to the enforcement agency foriall applicable inspections. I unde�stand'thaf a registered copy of thissCertifiicate of
Verification isSrequired to be iricluded with'the•documentation the b6ild"erprovides to the building owner at occupant j—
i'. It
C N.,,,, . w✓ j / � ✓' I' � � M
Builder Or Installer Information As -Shown On The Certificate Of Installation
Company Name (Installing Subcontractor, General Contractor, or Builderwre 0 rEnergyhaters Association
JC HERS RATING
Responsible Builder or Installer Name:
CSLB License:
Jose Cervantez
1095730
HERS Provider Data Registry Information
Sample Group Number (if applicable):
Dwelling Test Status in Sample Group (if applicable)
316-18260
Tested
HERS Rater Information
HERS Rater Company Name:
JC HERS RATING
Responsible Rater Name:
Jose Cervantez
Responsible Rater Signature:
✓RhTP�
�C�erwantez
a 4, 2016
Responsible Rater Certification Number w/ this HERS Provider:
Date Signed:
1095730
2016-05-04
Til?
This digital signature is provided in order to secure
f� the content of this registered document, and in no
way implies Registration Provider responsibility for
U.S. Energy Raters Aswctatian the accuracy of the information."
Registration Number: 316-A1024585A-M2010171A-M20A Registration Date/Time: 2016-05-04 04:31:40 HERS Provider: USERA
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-05-04 04:32:03
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION
CF2R-MCH-20-H
Duct Leakage Diagnostic Test
(Page 1 of 3 )
Project Name: 530 Cameron Crest Dr.
Enforcement Agency: Diamond
Bar Building Department
Permit Number:
PR16-1085
Dwelling Address: 530 Cameron Crest Dr.
City:
Zip Code:
91765
A. System Information
O1
Space Conditioning System Identification or Name
System 1
02
Space Conditioning System Location or Area Served
House
03
Building Type from CF -111
Single family
04
Verified Low Leakage Ducts in Conditioned Space
No, credit is not taken
05
(VLLDCS) Credit from CF1R?
Total leakage
05
Verified Low Leakage Air Handling Unit (VLLAHU) Credit
No, credit is not taken
07
from CF1R?
Cooling system method
06
Duct System Compliance Category
Replacement
09
Calculated Target Allowable Duct Leakage (cfm)
120
MCH -20d -Complete Replacement or Altered Duct Sys#em -• Ff
i f e
B. Duct Leakage+Diagnostic Test
01
Condenser Nominal Cooling Capacity (ton) U.S. Energy
Raters Association
02
Heating Capacity (kBtu/h)
80.00
03
Conditioned Floor Area served by this HVAC system (ft2)
2835
04
Duct Leakage Test Condition
Test final
05
Duct Leakage Test Method
Total leakage
06
Leakage Factor
.06
07
Air Handling Unit Airflow (AHUAirflow) Determination
Method
Cooling system method
08
Measured AHUAirflow
0
09
Calculated Target Allowable Duct Leakage (cfm)
120
10
Actual duct leakage rate from leakage test measurement
(cfm)
66
11
Compliance Statement
System passes leakage test
Registration Number: 316-A1024585A-M2012466A-0000 Registration Date/Time: 2016-05-04 04:29:21 HERS Provider: USERA
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-05-04 04:29:44
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-20-H
Duct Leakage Diagnostic Test (Page 2 of 3 )
C. Additional Requirements for Compliance
01
System was tested in its normal operation condition. No temporary taping allowed.
Outside air (OA) duct connections to the central forced air duct system shall not be sealed/taped off during duct leakage
02
testing. OA ducts used for Central Fan Integrated (CFI) Indoor Air Quality ventilation systems, or Central Fan Ventilation
Cooling Systems, that utilize dampers that open only when OA is required and automatically close when OA is not required,
may configure the OA damper to the closed position during duct leakage testing.
03
If a complete replacement, all supply and return register boots were sealed to the drywall.
04
Building cavities were not used as plenums or platform returns in lieu of ducts.
05
If cloth backed tape was used it was covered with Mastic and draw bands.
06
All connection points between the air handler and the supply and return plenums are completely sealed.
If the system complies using the Smoke Test method, the smoke test was conducted in accordance with the requirements
07
of Reference Residential Appendix RA3.1.4.3.6. Systems that comply using smoke test shall not be included in sample
groups for HERS verification compliance.
The responsible `persons signature on this compliance document affirmsthat all applicable requirements Wthis table have
been met.
1
U.S. Energy Raters Association
Registration Number: 316-A1024585A-M2012466A-0000 Registration Date/Time: 2016-05-04 04:29:21 HERS Provider: USERA
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-05-04 04:29:44
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-20-H
Duct Leakage Diagnostic Test (Page 3 of 3)
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature.
Jose Cervantez
a
Company:
Signature Date:
JC HERS RATING
2016-05-04
Address:
CEA/ HERS Certification Identification (if applicable):
136 Half Dome Way
1095730
City/State/Zip:
Phone:
Perris CA 92570 1951-217-0805
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design,
construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of
Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the
responsible builder/installer.
3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation
conformsto,1 applicableicodes and regulations, and the installation.conformsto the,requirements.given on the plans.and.specifications approved by
the enforcement agency.
4. 1 understand that a HERS rater.ill check the installation to 4enfy compliance, and that, if such checking identifies defects• I amyequired to take
corrective action at my expense. I u dr
erstand that.E;ergy Commission and'HERS Provide,representaiives.will also perform quality assurance checking
of installations, including those approved as part of a sample group,but not checked by HERS rater, and'if those installations fail'to meet the
requirements1of such quality assurance checking, the required corrective action and l dditional'checking/testing\of other installations in that HERS
sample group will be performed at my expense: f{ n t
5. 1 reviewed a,copy of the Certificate of,Compliance approved by the enforcement agency that identifies the specific regwrements for scope of
construction or installation identified on this Certificate of Installation, and I have ensured that the requirements that apply to the construction or
installation have been met. U.S. Energy Raters Association
6. 1 will ensure that a registered copy of this Certificate of Installation shall be posted, or made available with the building permit(s) issued for the
building, and made available to the enforcement agency for all applicable inspections. I understand that a registered copy of this Certificate of
Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
Responsible Builder/Installer Name:
Responsible Builder/Installer Signature:
Jose Cervantez
Company Name: (Installing Subcontractor or General Contractor or
Position With Company (Title):
Builder/Owner)
HERS RATING' -Jose Cervantez (May 4, 2016)
JC HERS RATING
Address:
CSLB License:
136 Half Dome Way
1095730
City/State/Zip:
Phone:
Date Signed:
Perris CA 92570
951-217-0805
12016-05-04
Third Party Quality Control Program (TPQCP) Status:
Name of TPQCP (if applicable):
TM
This digital signature, is provided in order to secure
the content of this registered document, and in no
way implies Registration Provider responsibility for
U.S. EnMy Raters Assocl3tton the accuracy of the information.'
Registration Number: 316-A1024585A-M2012466A-0000 Registration Date/Time: 2016-05-04 04:29:21 HERS Provider: USERA
CA Building Energy Efficiency Standards Report Version: 2013 Rev 1.007 Report Generated: 2016-05-04 04:29:44
2013 Residential Compliance Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION
CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans
(Page 1 of 8 )
Project Name: 530 Cameron Crest Dr.
Enforcement Agency: Diamond Bar Building
Department
Permit Number:
PR16-1085
Dwelling Address: 530 Cameron Crest Dr.
City:
Zip Code:
91765
A. General Information
01
Dwelling Unit Name
530 Cameron Crest Dr.
02
Climate Zone
9
03
Dwelling Unit Total Conditioned Floor
2835
04
Number of Space Conditioning
1
Area (ft2)
Systems in this Dwelling Unit.
05
Certificate of Compliance Type
Prescriptive alterations (CF1R-ALT)
06
Method used to Calculate HVAC Loads
ASHRAE_Handbook
07
Calculated Dwelling Unit Sensible
60000
08
Calculated Dwelling Unit Heating Load
80000
Cooling Load (Btuh)
Location or Area
by this SC
(Btuh)
containing
09
Dwelling Unit Number of Bedrooms
4
entirely new SC
Alteration Type
Name
MCH -01b Prescriptive Alterations - Space. Con ditioning.Systems.Ducts.and-Fans
B. Space Conditioning (SC) System'lnfor t o'nLN
01
'\--_,,02' /'-,-03—,}
- ._.03,/}
04.__..__u._
_.s{ 05
\06
�' 0'7
08
09
10
, �,
System
SCS stem
SCS stem
y
CFA served
Is e4C
)
s eia
1 s alli a
niffl T� R
r igerant
t. iaian ^ CJ
`J a�Lglmore
Installing
Installing
Identification or
Location or Area
by this SC
ducted
containing
system
than 40 feet of
entirely new
entirely new SC
Alteration Type
Name
Served
System (ft)
y (
system?
component?
components?
ducts?
duct system?
system?
Entirely new or
complete
System 1
House
2835
Yes
Yes
Yes
Yes
Yes
Yes
replacement space
conditioning
system
Registration Number: 316-A1024585A-M0117724A-0000 Registration Date/Time: 2016-05-04 04:27:40 HERS Provider: USERA
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-04 04:28:03
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 2 of 8 )
C. Space Conditioning (SC) System Alterations Compliance Information
01
02
03
04
05
06
07
08
09
10
11
12
13
Heating Unit
Manufacturer
Heating Unit
Model Number
w
Heating Unit serial
number
Rated Heating Capacity,
Output (BTUH)
S stem�l }
l.. AFUE
- " " 780-1"`""
Amana
,
N/A
N/A
80000
Notes:
1
Central Fan
SEER
13.000
Amana
N/A
N/A
60000
5.0
Integrated
Heating
Cooling
New or
(CFI)
System
Altered
Heating
Minimum
Altered
Cooling
Minimum
Required
Replaced
New
Ventilation
Identification
Heating
Heating
Efficiency
Efficiency
Cooling
Cooling
Efficiency
Efficiency
Thermostat
Duct
Duct
System
or Name
System Type
Component
Type
Value
System Type
Components
Type
Value
Type
Length
R -Value
Status
All new
All new
System 1
Central gas
heating
AFUE
.780
Central
cooling
SEER
13.000
Setback
LTE40Ft
R6
Not a CFI
furnace
componen
split AC
components
system
is
D. Installed Heating Equipment Information
01
02
03
04
05
06
07
System Identification or
Name
Heating Efficiency Type
Heating Efficiency
Value
Heating Unit
Manufacturer
Heating Unit
Model Number
w
Heating Unit serial
number
Rated Heating Capacity,
Output (BTUH)
S stem�l }
l.. AFUE
- " " 780-1"`""
Amana
,
N/A
N/A
80000
Notes:
1
k
SEER
E. Installed Cooling -Equipment information
01
02
113a- r-1
ICII gV4 "01ju 0 10-saJV
ICIltiwdU
07
08
Condenser or Package Unit
System Identification
or Name
Cooling Efficiency
Type
Cooling Efficiency
Value
Condenser or
Package Unit
Manufacturer
Condenser or
Package Unit
Model Number
Condenser or
Package Unit
Serial Number
System Rated Cooling
Capacity at Design
Conditions (BTUH)
Condenser Rated
Nominal Capacity
(ton)
System 1
SEER
13.000
Amana
N/A
N/A
60000
5.0
Registration Number: 316-A1024585A-M0117724A-0000 Registration Date/Time: 2016-05-04 04:27:40 HERS Provider: USERA
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-04 04:28:03
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 3 of 8 )
E. Installed Cooling Equipment information
01 02 03
04 05 06
07 08
04
Condenser or Package Unit
06
System Identification
or Name
Cooling Efficiency
Type
Cooling Efficiency
Value
Condenser or
Package Unit
Manufacturer
Condenser or
Package Unit
Model Number
Condenser or
Package Unit
Serial Number
System Rated Cooling
Capacity at Design
Conditions (BTUH)
Condenser Rated
Nominal Capacity
(ton)
Notes:
F. Extension of Existing Duct System, Greater Than 40 Feet
This section does not apply to this project.
G. Installed Duct System information
01
02
03
04
05
06
07
08
09
Method of
Can RA3.3
SC System 1
Identification or
Name
j`
SC System'
Location or Area
Served
Supply Duct
--Location
Supply Duch
'R=Value
Return Duct
— Location
j7
Return°Duct
% R Value
compliance with
duct and filter
grille sizing Reqs
in 150.0(m)13
Number of Air
Filter Devices on
System
Airflow
Protocols be
used to test
this system?
System 1
House
- —Unconditioned" -
attic ��
�- _--s
�� net
Unconditioned"
1� i'S A
SSO R-,6 ti0
Altered system -
1150.0(m)13 is not
applicable
0
No
Notes:
H. Installed Air Filter Device Information
This section does not apply to this project.
Registration Number: 316-A1024585A-M0117724A-0000 Registration Date/Time: 2016-05-04 04:27:40 HERS Provider: USERA
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-04 04:28:03
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 4 of 8 )
1. Air Filter Device Requirements
01
The system shall be designed to ensure that all recirculated air and all outdoor air supplied to the occupiable space is filtered before passing through the system's
thermal conditioning components.
The system shall be designed to accommodate the clean -filter pressure drop imposed by the system air filter device(s). The design airflow rate and maximum
allowable clean -filter pressure drop at the design airflow rate applicable to each air filter device shall be determined, and all system air filter device locations shall be
02
labeled to disclose the applicable design airflow rate and the maximum allowable clean -filter pressure drop. The labels shall be permanently affixed to the air filter
device, readily legible, and visible to a person replacing the air filter media, and the air filter devices shall be provided with air filter media that conforms to these
determined or labeled maximum allowable clean -filter pressure drop values as rated using AHRI Standard 680.
03
All system air filter devices shall be located and installed in such a manner as to allow access and regular service by the system owner.
The system shall be provided with air filter media having a designated efficiency equal to or greater than MERV 6 when tested in accordance with ASHRAE Standard
04
52.2, or a particle size efficiency rating equal to or greater than 50 percent in the 3.0 to10 micron range when tested in accordance with AHRI Standard 680.
The system shall be provided with air filter media that has been labeled by the manufacturer to disclose the efficiency and pressure drop ratings that conform to the
05
required efficiency and pressure drop requirements for the air filter device.
The responsible persons signature on this compliance document affirms that all applicable requirements in this table have been met.
U.S. Energy Raters Association
Registration Number: 316-A1024585A-M0117724A-0000 Registration Date/Time: 2016-05-04 04:27:40 HERS Provider: USERA
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-04 04:28:03
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 5 of 8 )
J. HERS Verification Requirements
O1
02
03
04
05
06
07
08
09
10
MCH20
MCH21
MCH22
MCH23
MCH25
MCH28
Exemption
from
Minimum
Exemption
R -Value for
AHU
System
SC System
From Duct
Duct
Ducts In
Ducts Located
AHU Fan
Airflow
Identification or
Location or Area
Leakage
Leakage
Conditioned
In Cond Space
Efficacy
Rate
Refrigerant
Return Duct Design
Name
Served
Requirements
Test
Space
Verification
(W/cfm)
(cfm/ton)
Charge
Table 150.0-C or D
System 1
House
No
Yes
No
No
Yes
Yes
Yes
No
exemptions
Exemption
Notes:
Registration Number: 316-A1024585A-M0117724A-0000
U.S. Energy Raters Association
Registration Date/Time: 2016-05-04 04:27:40
HERS Provider: USERA
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-04 04:28:03
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 6 of 8 )
K. Space Conditioning Systems, Ducts and Fans Mandatory Requirements and Additional Measures
Note: Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to some systems. These requirements may be applicable to only newly installed equipment or portions of the
system that are altered. Existing equipment may be exempt from these requirements.
Heating Equipment
01
Equipment Efficiency: All heating equipment must meet the minimum efficiency requirements of Section 110.1 and Section 110.2(a) and the Appliance Efficiency
Regulations.
02
Controls: All unitary heating systems, including heat pumps, must be controlled by a setback thermostat. These thermostats must be capable of allowing the occupant
to program the temperature set points for at least four different periods in 24 hours. See Sections 150.0(1), 110.2(b).
03
Sizing: Heating load calculations must be done on portions of the building served by new heating systems to prevent inadvertent undersizing or oversizing. See sections
150.0(h)1 and 2).
04
Furnace Temperature Rise: Central forced -air heating furnace installations must be configured to operate at or below the furnace manufacturer's maximum
inlet -to -outlet temperature rise specification. See Section 150.0(h)4.
05
Standby Losses and Pilot Lights: Fan -type central furnaces may not have a continuously burning pilot light. Section 110.5 and Section 110.2(d).
Cooling Equipment
Equipment -Efficiency: All cooling egdipment;T ust meet the minimum efficiencyrequirements of;Section 110.1 and Section 110.2(a) and the Appliance Efficiency
06
Regulations.~ h�' \ I 1 ' s
i
Refrigerant Line Insulation: II refrigeranline insulation in split system aircondi'tioners and heat.pumps must meet the R -value and protection requirements of Section
07
t `. 1 ° � 'E f
�
150.0(1)2 and 3,and'S��on 1500(m)9. ; w ' sh
08
Condensing Unit Location: Condensing units shall n �t b la eC� LVi f- er-%ftLUftdyy�efS)Sa j&tt��,e-ef3ection 150.0(h)3A.
09
Sizing: Cooling load calculations must be done on portions of the building served by new cooling systems to prevent inadvertent undersizing or oversizing. See Section
150.0(h)1 and 2.
Air Distribution System Ducts, Plenums and Fans
10
Insulation: In all cases, unless ducts are enclosed entirely in directly conditioned space, the minimum duct insulation value is R-6. Note that higher values may be
required by the prescriptive or performance requirements. See Section 150.0(m)1.
Registration Number: 316-A1024585A-M0117724A-0000 Registration Date/Time: 2016-05-04 04:27:40 HERS Provider: USERA
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-04 04:28:03
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 7 of 8 )
K. Space Conditioning Systems, Ducts and Fans Mandatory Requirements and Additional Measures
Note: Additional mandatory requirements from Section 150.0 that are not listed here may be applicable to some systems. These requirements may be applicable to only newly installed equipment or portions of the
system that are altered. Existing equipment may be exempt from these requirements.
Connections and Closures: All installed air -distribution system ducts and plenums must be, sealed and insulated to meet the requirements of CMC Sections 601.0,
602.0, 603.0, 604.0, 605.0 and ANSI/SMACNA-006-2006: Supply -air and return -air ducts and plenums must be insulated to a minimum installed level of R-6.0 or
11
enclosed entirely in directly conditioned space as confirmed through field verification and diagnostic testing in accordance with the requirements of Reference
Residential Appendix RA3.1.4.3.8.
Heat Pump Thermostat
12
A thermostat shall be installed that meets the requirements of Section 110.2(b) and Section 110.2(c).
13
The thermostat shall be installed in accordance with the manufacturers published installation specifications
14
First stage of heating shall be assigned to heat pump heating.
15
Second stage back up heating shall be set to come on only when the indoor set temperature cannot be met.
The responsible person signature on this compliance document affirms that all applicable requirements in this table have been met.
Registration Number: 316-A1024585A-M0117724A-0000
I t 3
_- I _X
U.S. Energy Raters Association
Registration Date/Time: 2016-05-04 04:27:40
HERS Provider: USERA
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-04 04:28:03
Schema Version: 2013.1.007
CERTIFICATE OF INSTALLATION CF2R-MCH-01-E
Space Conditioning Systems, Ducts, and Fans (Page 8 of 8 )
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Installation documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature:T
"�
Jose Cervantez
g
Signature Date:
Company:
JC HERS RATING
2016-05-04a
Address:
CEA/ HERS Certification Identification (if applicable):
136 Half Dome Way
1095730
City/State/Zip:
Phone:
Perris CA 92570
951-217-0805
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1.. The information provided on this Certificate of Installation is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials,
components, or manufactured devices for the scope of work identified on this Certificate of Installation, and attest to the declarations in this statement (responsible builder/installer), otherwise I am an
authorized representative of the responsible builder/installer.
3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the
installation conforms to the requirements given on the plans and specifications approved by the enforcement agency.
4. 1 reviewed.a.copy of the Certificate of Compliance,approved by-the.enforcement agency -that identifies the specific requirements for the scope of construction or installation identified on this Certificate of
Installation, and I have ensured that requirements:thatapply to,the_construction or installation have -been met. f
5. 1 will ensure -that a registered copy ofthis Certificate;of Installation shall be posted, or made available withthe building permits) issued for the building, and made available to the enforcement agency for all
,
_.r i. ,.y_.
applicable inspections I understand that a registered copy of this Certificate of Installation is required to be included with the documentation the builder provides to the building owner at occupancy.
31
Responsible Builder/Installer Name g ' "
'Responsible Builder/Installer Signature:
Jose Cervantez
_ _
Company Name: (Installing,SubconMtracto(orGeneral Contractor,`of Build_er/Ownee) z' ` r
Position With Company (Title* - , OSS V ZA17Z2
JC HERS RATING r ,
as _ ose Cervantez (May 4, 2016)
Address: unel,wgy U10165-LB'+L�ic
VtriQilV' 1
136 Half Dome Way
1095730
City/State/Zip:
Phone:
Date Signed:
Perris CA 92570
951-217-0805
12016-05-04
n -T TM
-� `This digilal signature is provided in order to secure
the content of this iegistered document, and in no
y.. - way implies Registration Provider responsibility for
UIS. Energy Raters Assxlatton the accuracy of, the'information."
Registration Number: 316-A1024585A-M0117724A-0000 Registration Date/Time: 2016-05-04 04:27:40 HERS Provider: USERA
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-04 04:28:03
Schema Version: 2013.1.007
CERTIFICATE OF COMPLIANCE
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC)
Project Name:
530 Cameron Crest Dr. I Date Prepared:
CF111-ALT-02-E
(Page 1 of 3 )
2016-05-04
A. General Information
MR -ALT -02 is applicable to multiple space conditioning systems contained within a single dwelling unit. When multiple dwelling units must be documented,
use one MR -ALT -02 document for each dwelling unit.
01
Project Name
530 Cameron Crest Dr.
02
Date Prepared
2016-05-04
03
Project Location
530 Cameron Crest Dr.
04
Building Type
Single family
05
CA City
06
Dwelling Unit Name
530 Cameron Crest Dr.
07
Zip Code
91765
08
Dwelling Unit Conditioned
2835
Installing
Installing
Installing
Floor Area (ft2)
Location or Area
by hi3"SC �
ducted"
containing—
��"1 system t'" �
Number of space conditioning
entirely new
09
Climate Zone
9
10
(SC) systems in this dwelling
1
component?-
component's?
-feet of,ducts?
duct system?
unit.
Alteration Type
B. Space Conditioning (SC) System Information
01
02
03
04
05
06
07
08
09
10
{ -
'
7 Is the SC
Installing a
SC System}{
SC Sy
CFA served./
systema
refrigerant
Installing new SC
Installing
Installing
Installing
Identification o'
Location or Area
by hi3"SC �
ducted"
containing—
��"1 system t'" �
more than 40
entirely new
entirely new
Name
Served .
system? ""
component?-
component's?
-feet of,ducts?
duct system?
SC system?
Alteration Type
RSystem-(ft2)
Entirely new or
.......
complete
System 1
House
2835
I,Ye.
E
Yes
erg
Yes Yes
iters ASS4t
Yes
tati0>T�
Yes
Yes
replacement space
V.b.
J
I
I conditioning system
C. Extension of Existing Duct System, Greater Than 40 Feet (Section150.2(b)1Diib)
This section does not apply to this project.
Registration Number: 316-A1024585A-000000000-0000
Registration Date/Time: 2016-05-04 04:24:28
HERS Provider: USERA
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-04 04:24:54
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CF111-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT HVAC) (Page 2 of 3 )
D. Altered Space Conditioning System (Sections 150.2(b)IE and F)
This section does not apply to this project.
E. Entirely New or Complete Replacement Duct System, with or without Equipment Changeout (Sections 150.2(b)iDiia and 150.2(b)1E, F)
This section does not apply to this project.
F. Entirely New or Complete Replacement Space Conditioning System (Section 150.2(b)IC)
O1
02
03
04
05
06
07
08
09
30
it
Heating
Cooling
System
Heating
Minimum
Cooling
Minimum
Required
Identification or
Heating System
Altered Heating
Efficiency
Efficiency
Cooling
Altered Cooling
Efficiency
Efficiency
Thermostat
New Duct
Name
Type
Component
Type
Value
System Type
Component
Type
Value
Type
R -Value
System 1
Central gas
All new heating
AFUE
80.00
Central split
All new cooling
SEER
14
SetbackTher
R-6
furnace
components
AC
components
mostat
Required Documentation:— _
CF2R-MCH-01-E Space C ditioning Syst tems Ducts and Fans- � `w ;y µ 7-7
_..
-Duct insulation reg�ement for new p3enums: R6.
w
CF2R & CF3R-MCH-20-H Dud Leakage Verification required.,
-Leakage rate compliance:5 6%. w /
CF2R & CF3R-MCH 22 Fan Efficacy Verification
CF2R & 23I Air Fl? Efficacy
CF3R-MCH ystem
-Compliance: Fan Efficacy15 0 WW/cfm and System AirfMW 3 �cFm/ton
- Alternative Compliance: CF2R,&-CF3R-MCH-28 Return,Duct-Design Verification -is an alternative to MCH -22 and MCH -23 verification.
CF211 & CF3R-MCH-25-H Refrigerant Charge Verification required when reff l�e ,apt c Thai i one �r ins filled o Iter d,�applic�b te'rr������.�zz, 8-15).
V17C1� RA
Exceptions: :J.�: �/ t: G wadLfdi�L71i
Heating -only systems are exempt from the 0.58 W/cfm and 350 cfm/ton requirements.
No e:
An "entirely new or replacement duct system" means at least 75 percent of the duct system is new duct material, and up to 25 percent may consist of reused parts from the dwelling unit's existing duct system (e.g.,
registers, grilles, boots, air handler, coil, plenums, duct material) if the reused parts are accessible and can be sealed to prevent leakage
Registration Number: 316-A1024585A-000000000-0000
Registration Date/Time: 2016-05-04 04:24:28
HERS Provider: USERA
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-04 04:24:54
Schema Version: 0.555SDD
CERTIFICATE OF COMPLIANCE CFIR-ALT-02-E
Alterations to Space Conditioning Systems (formerly CF -IR -ALT -HVAC) (Page 3 of 3 )
Documentation Author's Declaration Statement
1.1 certify that this Certificate of Compliance documentation is accurate and complete.
Documentation Author Name:
Documentation Author Signature '
Jose Cervantez"
Signature Date:
Company:
JC HERS RATING
2016-05-04
Address:
CEA/ HERS Certification Identification (if applicable):
136 Half Dome Way
1095730
City/State/Zip:
Phone:
Perris CA 92570
951-217-0805
Responsible Person's Declaration statement
I certify the following under penalty of perjury, under the laws of the State of California:
1. The information provided on this Certificate of Compliance is true and correct.
2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer).
3. That the energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the
requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations.
4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets,
calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application.
5. 1 will ensure'that a registered'copy of this°Certificate_offCCompliance shall-be-macle available-withthe building permit(s) issuedfor the building, and made available to the enforcement agency for all applicable
inspections.'I understand that a'.registered.copy-of tthis Certificate of.Compliance�is required.to.be:included�vith the documentation the builder provides to the building owner at occupancy.
Responsible Designer Narnie: .. ^-
'
Responsible Desg Sign /natu` :
OSS ��✓R�+!e2
Jose Cervantez !`\
;`
Company:.Date
M --._.
Signed:
JC HERS RATING j
-
2016``-05 04� y.
Address:V111
136 Half Dome Way U.S. Energy Ra
License: qq
M73ssociation
City/State/Zip:
Phone:
Perris CA 92570
951-217-0805
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Registration Number: 316-A1024585A-000000000-0000
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U.S. Energy Raters,
"This digital signature is provided in order to secure
the content of this registered document, and in no
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the accuracy of the information."
Registration Date/Time: 2016-05-04 04:24:28
HERS Provider: USERA
CA Building Energy Efficiency Standards - 2013 Residential Compliance Report Version: 2013 Rev 1.007 Report Generated: 2016-05-04 04:24:54
Schema Version: 0.555SDD